If you notice a colleague exhibiting signs of a mental illness or dementia, do you know what to do? According to Robin Belleau, clinical director of the Illinois Lawyers’ Assistance Program, help is available through your state’s lawyers’ assistance program.

Speaking at the ABA-CLE “Facing Mental Illness and Dementia in Law Practice,” Belleau says that such programs were established almost three decades ago to address alcohol abuse, but they now provide assistance for a range of disorders—from low-level stress and anxiety, to addiction, clinical depression and other mental disorders.

“Confidentiality is the cornerstone of the Illinois Lawyers’ Assistance Program and lawyers’ assistance programs across the nation,” assures Belleau.

While help across the nation is available, starting a conversation with someone you believe needs help can be awkward and difficult. Because lawyers often see themselves as problem solvers, fixing clients’ problems, they sometimes have a hard time seeing their own issues, explains Belleau, also noting that the stigma of mental illness keeps many people from acknowledging symptoms and seeking help.

“It’s important to have specific situations or examples that you can clearly give them,” Belleau advises. She also points out that help in designing an approach is available. “Your lawyers’ assistance program locally can work with you and your partners on what to say, how to approach it and the specifics.”

Eliminating misconceptions about LAPs can pave the way to accepting help, and one of the biggest involves confidentiality. As Belleau assures, “Confidentiality is the cornerstone of the Illinois Lawyers’ Assistance Program and lawyers’ assistance programs across the nation.” There is never any reporting and only demographic information is made public.

“We are not allowed to speak with anyone without your permission. Specifically, we would have you sign a release form so that we could speak to someone, if you asked us to,” says Belleau. Such release forms allow LAP staff to advocate on behalf of the person seeking treatment with a disciplinary commission or her employer.

While help is individualized, lawyers generally start with an assessment and referral to an appropriate provider for services such as individual therapy, group counseling and residential treatment. Some LAPs have on-site support groups as well as brief counseling to augment outside services.

Throughout treatment, LAPs typically track their participants’ progress to ensure proper follow-through. Such case management is usually voluntary, though it is sometimes mandatory when the LAP is tied to a state’s licensing entity. Even when voluntary, “case management can be a useful tool in mitigating your disposition with a licensing board,” advises Belleau.

Cost of services vary from state to state, “but typically lawyers’ assistance programs do not charge for their services,” says Belleau, explaining that funding can come from attorney registration fees, state supreme courts and bar associations.

Resistance is not an uncommon response to an initial conversation with a colleague. If a more formal intervention is needed, an LAP can also help—including organizing the intervention team and working with the firm of the person in need of services.

“It’s definitely a group process,” Belleau explains, “We do our best to have as many people there as possible in terms of family and colleagues. Teams with the Illinois LAP also include a judge, an LAP volunteer who successfully managed a similar problem and sometimes, a clinician as well.

“The goal is to offer hope and initiate change,” says Belleau. Dismantling denial is also key.

“Typically we have an appointment or assessment or even a plane ticket ready to go for that person as soon as he or she leaves the intervention,” says Belleau, emphasizing the importance of planning a post-intervention plan of action.

“All reports, findings and proceedings and data regarding interventions are kept confidential and not admissible in legal proceedings,” emphasizes Belleau.

The ABA provides further information on LAPs through its Commission on Lawyer Assistance Programs. The commission operates a confidential toll-free hotline (1-866-LAW-LAPS) for referrals to local programs.

In addition to Belleau, Eric Drogin, professor at the Harvard Medical School, was a panelist.

“Facing Mental Illness and Dementia in Law Practice” was sponsored by the Commission on Mental and Physical Disability Law; General Practice, Solo & Small Firm Division; Health Law Section; Commission on Lawyer Assistance Programs; Law Practice Management Section; Senior Lawyers Division; and the ABA Center for Continuing Legal Education.